​Wake County EMS has a fleet of more than 35 ambulances and other response vehicles. All EMS vehicles operate with a replacement cycle to maximize usage while keeping state-of-the-art technologies on the street. The primary-response units are Type-III modular units and feature cab extensions for crew comfort.

All response units feature Automatic Vehicle Location (AVL) equipment, a GPS-based system that allows the emergency communications center to dispatch the closest available units to any incident. This equipment includes an integrated application for navigation and routing.

Wake County EMS operates a Major Operations Support vehicle ("Truck 1"), which is equipped to respond to multiple-patient incidents, provide responder rehabilitation and support EMS Special Operations missions.

In addition, Wake County EMS operates a Multiple Patient Transport Unit ("EVAC-1"), which is an ambulance on a bus chassis. The unit is capable of transporting about 22 people sitting up, 14 stretcher-bound patients or 14 wheelchair-bound patients, depending on configuration. The vehicle is also useful as a temporary shelter from extremely hot or cold weather conditions during an emergency.